Kneadable and pliable bone replacement material

ABSTRACT

A kneadable and moldable bone-replacement material includes a mixture of calcium-containing ceramic particles and a hydrogel or a substance which can be swelled into a hydrogel. The ceramic particles are of fully synthetic origin and the individual ceramic particles have a structure which is at least partially cohesive and porous. In addition, the majority of the ceramic particles have a non-spheric shape.

The invention concerns a kneadable and moldable bone-replacementmaterial in accordance with the general term of patent claim 1.

Under current standards of technology it is common practice to useblocks or granulates made from synthetically produced calcium phosphatefor re-filling of defective bones. The disadvantages of this materiallie in the fact that the blocks must be tailored to the shape of thedefective bone they are to be used on as well as in the fact that thetime spent in the application of the loose granulates is not at optimumlevel.

In addition, materials which can be injected are also known. Thesehowever consist mainly of spheric particles (small balls). Thesematerials with spheric balls can be injected more easily into the bonebecause the small balls slide past each other with greater ease. Thishowever is a disadvantage in the case of kneadable and moldablebone-replacement materials, as they are meant to be kneaded rather thaninjected. Such a material should therefore be cohesive, a requirementwhich is not met by spheric particles.

In the following text, the term “particle” includes anythree-dimensional body, regardless of its dimensions, especially thesmall parts commonly known as “granulate” or “grains”.

This discussion regarding current standards of technology is used onlyto explain the environment of the invention and does not mean that thestandards of technology quoted here were actually published or publiclyknown at the time of this registration or its priority.

This invention is meant to provide a remedy for this situation. Theinvention is based on the problem of creating a kneadablebone-replacement material which overcomes the disadvantages listedabove, especially the shaping and the time required for application.

The invention solves this task through a kneadable and moldablebone-replacement material which has the characteristics of claim 1.

The advantage of eliminating the danger of transferring diseases due tothe absence of possible pathogenic agents such as proteins, germs,viruses or bacteria as compared to bone-replacement materials of naturalorigin is thus achievable.

Another advantage lies in the fact that it is no longer necessary totransfer the loose ceramic particles laboriously one by one to thedesired location of use. Instead, using the kneadable bone-replacementmaterial, the required total quantity of ceramic particles can betransferred to the location of use quickly and easily. In addition,non-spheric and especially angular particles encourage ceramicresorption and accelerate tissue growth and bone recovery. Compared tomaterials with nearly spheric particles, the non-spheric and especiallythe angular particles improve the cohesion of the kneadable material.

“Non-spheric” describes any particle shape which is significantlydifferent from a spheric shape. One variant of the invention usesceramic particles with an angular shape. “Angular” describes thoseparticles which have individual edges, especially those which arevisible with the naked eye, i.e. which are at least 0.1 mm in size.

Compared to round particles, this results in an increase to the particlesurface, while the average particle diameter remains the same. Thiscauses the adhesive interaction between the particles and the hydrogelto be increased, guaranteeing the moldability of the bone-replacementmaterial without the need for increasing the quantity of hydrogel usedor its concentration.

There is also a special variant whose ceramic particles have a sphericrelationship S=Dmax/Dmin between the largest diameter Dmax and thesmallest diameter Dmin of the individual particles, which is larger than1.2 and preferably larger than 1.5. The value of S should be larger than3 and preferably larger than 5.

At least 60% and typically at least 80% of the ceramic particles shouldbe of a non-spheric shape.

The pore size of the ceramic particles should be between 1 and 500micrometers. The ceramic particles typically have a share of macroporeswhich are between 100 and 500 micrometers in size and a share ofmicropores which are between 1 and 100 micrometers in size. Thisguarantees optimum pore size distribution and the growth of autogenoustissue through the pores. The porosity of the ceramic particles shouldbe between 60 and 90 percent. This ensures that autogenous tissue isable to grow through a larger volume share of ceramic particles.

The bulk density of the ceramic particles should between 0.2 g/ccm and2.0 g/ccm. It is typically between 0.6 g/ccm and 1.0 g/ccm andpreferably between 0.7 g/ccm and 0.9 g/ccm. In one variant, the bulkdensity of the ceramic particles is between 1.0 g/ccm and 2.0 g/ccm,preferably between 0.2 g/ccm and 1.8 g/ccm.

The advantage of the higher bulk density ranges is a higher mechanicalstability, the disadvantages however are slower resorption and slowerbone re-growth. The advantages of lower bulk density ranges are fasterresorption and improved bone re-growth.

The jarring density of the ceramic particles should be between 0.5 g/ccmand 2.5 g/ccm, preferably between 0.7 g/ccm and 1.1 g/ccm or between 1.1g/ccm and 2.5 g/ccm.

The apparent density of the ceramic particles can be further increasedby using ceramic particles of different grain sizes. The interstitialspace (dead volume) between the larger particles is filled by smallerparticles. The intercaling of the ceramic particles further improves themechanical characteristics of the kneading material.

The average diameter of the ceramic particles should be between 100 and250 micrometers. The advantage of this is the fact that thebone-replacement material is compact. In addition, the risk ofirritation within the tissue surrounding the particles is practicallynon-existent, if the diameter of the particles is not smaller than 100micrometers.

The average diameter of the ceramic particles can also be between 150and 500 micrometers or between 0.5 and 5.6 mm for more efficient fillingof medium-sized and larger defects.

It is also possible to mix ceramic particles with an average diameterbetween 100 and 250 micrometers and particles with an average diameterbeweeen 250 and 500 micrometers or an average diameter between 0.5 and5.6 mm. This has the advantage that it guarantees the compactness of thebone-replacement material. The interstitial pore volume (pore deadvolume) which results from the use of large-grain material can thus bereduced to a minimum. It is also possible to affect the degredationperiod of the hardened bone-replacement material through the use ofceramic particles of various sizes.

The ceramic particles should consist of a calcium-phosphate, typicallybeta-tricalcium-phosphate. This means that a ceramic is being used whosestoichiometric makeup is very close to that of the human bone. Inaddition, the degradation period of beta-tricalcium-phosphate is neithertoo fast nor too slow, preventing the development of hollow spaces orimplanter residue during degradation.

The ceramic particles consisting of calcium-phosphate have the advantageof possessing a molar Ca/P relationship in the range between 1.0 and 2.0and preferably in the range between 1.45 and 1.52. The range between1.45 and 1.49 is preferred.

The calcium-phosphate can be selected from the following group:Dicalcium-phosphate-dihydrate (CaHPO4×2 H2O), dicalcium-phosphate(CaHPO4), alpha-tricalcium-phosphate (alpha-Ca3(PO4)2),beta-tricalcium-phosphate (beta-Ca3(PO4)2), calcium-deficienthydro-xylapatite (Ca9(PO4)5(HPO4)OH), hydro-xylapatite (CA10(PO4)6OH)2),carbonated apatite (Ca10(PO4)3(CO3)3(OH)2), flouride-apatite(Ca10(PO4)6(F,OH)2), chloride-apatite (Ca10(PO4)6(Cl,OH)2), whitlockite((Ca,Mg)3(PO4)2), tetracalcium-phosphate (Ca4(PO4)2O), oxyapatite(CA10(PO4)60), beta-calcium-pyrophosphate (beta-Ca2(P2O7),alpha-calcium-pyrophosphate, gamma-calcium-pyrophosphate,octo-calcium-phosphate (Ca8H2(PO4)6×5H2O).

The ceramic particles may also consist of a mixture of differentcalcium-phosphates. The advantage of such a mixture lies in the controlof the resorption period. Due to the differing resorption behaviours ofthe mixture components, faster bone growth into the cavities ofcomponents with faster resorption times can be facilitated.

The ceramic particles can also consist of calcium-sulfate orcalcium-carbonate.

For a special variant, the ceramic particles can be selected from thefollowing group: alpha-calcium-sulfate-hemihydrate,beta-calcium-sulfate-hemihydrate, calcium-sulfate-dihydrate.

For another variant, the ceramic particles may consist of a mixture ofdifferent calcium-phosphates, calcium-sulfates and/orcalcium-carbonates. The advantage of such a mixture lies in the controlof the resorption period. Due to the differing resorption behaviours ofthe mixture components, faster bone growth into the cavities ofcomponents with faster resorption times can be facilitated.

The non-spheric particles can be generated by breaking or grinding oflarger porous blocks of the desired material. The desired particle sizescan be achieved by using appropriate sieves.

For a special variant, the bone-replacement material may also containmetallic or semi-metallic ion shares. The advantages of such ioncontents are their impact upon the resorption behaviour of the ceramic,allowing optimum replacement of the mineral composition of the bone.

The matrix which the hydrogel consists of or the substance which may beswelled into a hydrogel may be selected from the following substancegroups:

-   -   a) fully synthetic substances;    -   b) natural biological substances of plant origin; and/or    -   c) biotechnologically generated substances.

The hydrogel or the substance which can be swelled into a hydrogel canalso consist of a mixture of fully synthetic, natural biological orbiotechnologically generated substances.

A hydrogel is present when a solid substance is hydrated via a liquidphase, changing and increasing the viscosity of the liquid phase, i.e.jellying or coagulating the liquid phase.

The hydrogel matrix can consist of oligomeric or polymeric shares or ofa combination of the two. Pharmaco-additives may be mixed into thebone-replacement material as required. The jellying liquid for thehydrogel can be water, especially deionised water and/or an organic,body-compatible solvent.

For a special variant, the hydrogel or the substance which can beswelled into a hydrogel contains one of the following components: a)polyamino-acids or their derivatives, preferably polylysin or gelatin;b) polysaccharides and their derivatives, preferably glycosaminoglycaneor alginate; c) polylipides, fatty acids and their derivatives; d)nucleotides and their derivatives; or a combination of the components aslisted in a) through d).

For another variant, the hydrogel or the substance which can be swelledinto a hydrogel contains one of the following synthetic components: a)polymethylenoxide or its derivatives; b) polyethylene, polyethylenoxideor their derivatives; c) polypropylene, polypropylenoxide or theirderivatives; d) polyacrylate or its derivatives; or a combination of thecomponents as listed in a) through d).

For a special variant, the hydrogel or the substance which can beswelled into a hydrogel is either a glycosaminoglycane or aproteoglycane or a mixture of those two substances. Theglycosaminoglycane can be a hyaluron-acid, chondroitinsulfate,dermatansulfate, heparansulfate, heparine or keratansulfate.

The concentration of the ready-to-use, hydrated hydrogel or theready-to-use, hydrated substance which can be swelled into a hydrogelshould be between 0.1% and 20.0%.

The molecular weight of the hydrogel or the substance which can beswelled into a hydrogel should exceed 300,000 Dalton and is preferred tobe above 500,000 Dalton. For another variant, the molecular weight ofthe hydrogel or the substance which can be swelled into a hydrogelexceeds 1,000,000 Dalton and is preferred to be above 1,500,000 Dalton.A larger molecular weight means that a smaller amount of hydrogel isrequired to achieve a certain level of viscosity. Therefore a largenumber of viscous jellies can be created with a relatively smallhydrogen content.

For a special variant, the hydrogel is a liquid solution of ahyaluronate. The hyaluron-acid consists of glucoron-acid andacetylglucosamine which create the disaccharide hyaluron-acid. Thehyaluron-acid has a fibrous, non-branced molecular structure andtherefore results in highly viscous liquid solutions.

The liquid solution of the hydrogel typically contains less than 99%water and preferably less than 98% water. In special cases, the liquidsolution may contain less than 96.5% water and preferably less than 95%water. Such concentrations have the advantage of guaranteeing theexcellent moldability of the bone-replacement material.

The molecular weight of the hyaluron-acid used should be larger than1.5×10⁶ Dalton. For a special variant, the molecular weight of thehyaluron-acid used is between 0.5×10 and 1.0×10⁶ Dalton.

For another variant, the molecular weight of the hyaluron-acid used issmaller than 1×10⁶ Dalton and preferably smaller than 0.5×10⁶ Dalton.

For a special variant, the specific gravity of the calcium-containing,porous ceramic particles is between 0.5 and 1.0 g/ccm.

For another variant, the weight relationship A/B between the hydratedhydrogel and the calcium-containing ceramic particles is larger than 0.2and preferably between 0.2 and 0.5.

For other variants, the weight relationship A/B is between 0.5 and 0.9or between 0.9 and 1.3 or between 1.3 and 2.0 or between 2 and 5 orlarger than 5.

The advantages of these different ranges for the weight relationship ofA/B lie in the different kneadabilities and resorption periods. A highcontent of substance A makes the material more kneadable, but increasesresorption; a high level of substance B makes the material lesskneadable, but reduces the rate of resorption.

The invention and further developments of the invention are explained inmore detail in the following application examples.

EXAMPLE 1

1.2 g of porous and angular granulate of beta-tricalcium-phosphate(β-TCP) with an approximate size of 500 micrometers and a sphericitydegree of S=3.1 were mixed with 2.0 g of a 5% liquid solution ofbiotechnologically generated natrium-hyaluronate with a molecular weightof 500 kD. The resulting kneadable material was highly suitable as aplastic bone-replacement material. It can be kneaded by hand as desired,molded into the desired shape and placed directly into the bone defectto be filled. The moldability allows optimum filling of bone defects.

EXAMPLE 2

A mixture of 0.6 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with an approximate size of 100micrometers and a sphericity degree of S=2.9 and 0.6 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with anapproximate size of 500 micron and a sphericity of S=2.7 was mixed with2.0 g of a 5% liquid solution of biotechnologically generatednatrium-hyaluronate with a molecular weight of 900 kD. The resultingkneadable material was highly suitable as a plastic bone-replacementmaterial.

EXAMPLE 3

A mixture of 0.3 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with an approximate size of 100micrometers and a sphericity degree of S=2.4 and 0.3 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with anapproximate size of 500 micron and a sphericity of S=2.3 was mixed with1.0 g of a 10% liquid solution of biotechnologically generatednatrium-hyaluronate with a molecular weight of 900 kD. The resultingkneadable material was highly suitable as a plastic bone-replacementmaterial.

EXAMPLE 4

A mixture of 0.3 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with an approximate size of 100micrometers and a sphericity degree of S=1.8 and 0.3 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with anapproximate size of 500 micron and a sphericity of S=2.7 was mixed with50 mg of biotechnologically generated natrium-hyaluronate with amolecular weight of 900 kD. Then 0.9 g of deionised water were added andthoroughly mixed for 10 minutes. The resulting kneadable material washighly suitable as a plastic bone-replacement material.

EXAMPLE 5

A mixture of 1.65 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 1.65 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with3.0 g of a sterile, liquid 6% solution of natrium-hyaluronate (molecularweight of the natrium-hyaluronate=900 kD) under sterile conditions usinga spatula. After 30 minutes, the material was placed into a sterile,tube-shaped container. This sterile kneadable material was highlysuitable as a plastic bone-replacement material.

EXAMPLE 6

A mixture of 1.5 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 2.5 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with3.0 g of a sterile, liquid 8% chitosane solution under sterileconditions using a spatula. After 30 minutes, the material was placedinto a sterile, syringe-like container. The resulting sterile kneadablematerial was highly suitable as a plastic bone-replacement material.

EXAMPLE 7

A mixture of 1.5 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 1.5 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with3.0 g of a sterile, liquid 5% solution of rhCollagen under sterileconditions using a spatula. The resulting sterile kneadable material washighly suitable as a plastic bone-replacement material.

EXAMPLE 8

A mixture of 1.5 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 1.5 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with2.5 g of a liquid 5% solution of natrium-alginate. The resultingkneadable material was highly suitable as a plastic bone-replacementmaterial.

EXAMPLE 9

3.0 g of porous and angular granulates of beta-tricalcium-phosphate(β-TCP) with a grain size of 125 to 500 micrometers and a sphericitydegree of S=2.9 were mixed with 2.5 g of a liquid 6.5% polyethylenglycolsolution (MG=35 kD) using a spatula. The resulting kneadable materialwas highly suitable as a plastic bone-replacement material.

EXAMPLE 10

3.0 g of porous and angular granulates of beta-tricalcium-phosphate(β-TCP) with a grain size of 125 to 500 micrometers and a sphericitydegree of S=2.9 were mixed with 2.0 g of a liquid 4% polyethylenoxidesolution (MG=511 kD) using a spatula. The resulting kneadable materialwas highly suitable as a plastic bone-replacement material.

EXAMPLE 11

3.0 g of porous and angular granulates of beta-tricalcium-phosphate(β-TCP) with a grain size of 125 to 500 micrometers and a sphericitydegree of S=2.5 were mixed with 2.2 g of a liquid 10% solution ofhydroxymethyl-cellulose using a spatula. The resulting kneadablematerial was highly suitable as a plastic bone-replacement material.

EXAMPLE 12

A mixture of 1.5 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 1.5 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with2.5 g of a liquid 7% solution of Ploronic 407. Ploronic 407 is asubstance with a chemical makeup of HO(C2H4O)a(C3H6O)b(C2H4O)aH witha=101 and b=56. The resulting sterile kneadable material was highlysuitable as a plastic bone-replacement material.

EXAMPLE 13

A mixture of 1.5 g of porous and angular granulates ofbeta-tricalcium-phosphate (β-TCP) with a grain size of 500 to 700micrometers and a sphericity degree of S=2.5 and 1.5 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 was mixed with2.5 g of a liquid solution consisting of 0.18 g of natrium-hyaluronate(MG=1.4 million Dalton) and 0.09 g of polyethylenoxide (MG=511 kD). Theresulting sterile kneadable material was highly suitable as a plasticbone-replacement material.

EXAMPLE 14

0.2 g of natrium-malginate (MG=50-500 kD) and 1.0 of porous and angulargranulates of beta-tricalcium-phosphate (β-TCP) with a grain size of 500to 700 micrometers and a sphericity degree of S=2.5 and 1.5 g of porousand angular granulates of beta-tricalcium-phosphate (β-TCP) with a grainsize of 125 to 500 micrometers and a sphericity of S=2.9 were mixedthoroughly when dry. 2.0 g of deposited water were then stirred intothis mixture. This resulted in a kneadable material which was able to beused as a plastic bone-replacement material.

EXAMPLE 15

0.18 g of natrium-hyaluronate (MG=1.1-1.3 million Dalton) and 1.0 ofporous and angular granulates of beta-tricalcium-phosphate (β-TCP) witha grain size of 500 to 700 micrometers and a sphericity degree of S=2.9and 1.5 g of porous and angular granulates of beta-tricalcium-phosphate(β-TCP) with a grain size of 125 to 500 micrometers and a sphericity ofS=2.5 were mixed thoroughly when dry. 0.5 ml of platelet-rich plasma and1.5 ml of sterile deionised water were then stirred into this mixture.After thorough mixing, this resulted in an excellent plastic kneadablematerial which was able to be used as a plastic bone-replacementmaterial.

EXAMPLE 16

0.18 g of natrium-hyaluronate (MG=1.1-1.3 million Dalton) and 1.0 ofporous and angular granulates of beta-tricalcium-phosphate (β-TCP) witha grain size of 500 to 700 micrometers and a sphericity degree of S=2.9and 1.5 g of porous and angular granulates of beta-tricalcium-phosphate(β-TCP) with a grain size of 125 to 500 micrometers and a sphericity ofS=2.5 were mixed thoroughly when dry. 2 ml of fresh blood were thenstirred into this mixture. After thorough mixing, this resulted in anexcellent plastic kneadable material which was able to be used as aplastic bone-replacement material.

EXAMPLE 17

A mixture of 0.6 g of porous and angular granulates ofdicalcium-phosphate-dihydrate (CaHPO4×2 H2O) with an approximate size of100 micrometers and a sphericity degree of S=2.9 and 0.6 g of porous andangular granulates of beta-tricalcium-phosphate (β-TCP) with anapproximate grain size of 500 micrometers and a sphericity of S=2.7 wasmixed with 2.0 g of a 5% liquid solution of biotechnologically generatednatrium hyaluronate with a molecular weight of 900 kD. The resultingkneadable material was highly suitable as a plastic bone-replacementmaterial.

EXAMPLE 18

A mixture of 0.6 g of porous and angular granulates ofdicalcium-phosphate (CaHPO4) with an approximate size of 100 micrometersand a sphericity degree of S=1.5 and 0.6 g of porous and angulargranulates of dicalcium-phosphate (CaHPO4) with an approximate size of500 micrometers and a sphericity of S=2.7 was mixed with 2.0 g of a 5%liquid solution of biotechnologically generated natrium hyaluronate witha molecular weight of 900 kD. The resulting kneadable material washighly suitable as a plastic bone-replacement material.

EXAMPLE 19

A mixture of 0.3 g of porous and angular granulates of calcium-deficienthydroxylapatite (CDHA; Ca9(PO4)5(HPO4)OH) with a specific surface of 55sqm/g, an approximate size of 125 micrometers and a sphericity degree ofS=1.8 and 0.3 g of porous and angular granulates of calcium-deficienthydroxylapatite (CDHA; Ca9(PO4)5(HPO4)OH) with a specific surface of 55sqm/g, an approximate size of 500 micrometers and a sphericity of S=2.3was mixed with 2.7 g of a 10% liquid solution of biotechnologicallygenerated natrium-hyaluronate with a molecular weight of 1.2 millionDalton. The resulting kneadable material was highly suitable as aplastic bone-replacement material.

EXAMPLE 20

A mixture of 0.3 g of porous and angular granulates of calcium-deficienthydroxylapatite (CDHA; Ca9(PO4)5(HPO4)OH) with a specific surface of 102sqm/g, an approximate size of 125 micrometers and a sphericity degree ofS=1.8 and 0.3 g of porous and angular granulates of calcium-deficienthydroxylapatite (CDHA; Ca9(PO4)5(HPO4)OH) with a specific surface of 102sqm/g, an approximate size of 500 micrometers and a sphericity of S=2.3was mixed with 2.7 g of a 10% liquid solution of biotechnologicallygenerated natrium-hyaluronate with a molecular weight of 1.2 millionDalton. The resulting kneadable material was highly suitable as aplastic bone-replacement material.

EXAMPLE 21

A mixture of 0.3 g of porous and angular granulates ofcalciumsulfate-hemihydrate with an approximate size of 125 micrometersand a sphericity degree of S=1.8 and 0.3 g of porous and angulargranulates of beta-tricalcium-phosphate (β-TCP) with an approximategrain size of 500 micrometers and a sphericity of S=2.3 was mixed with2.7 g of a 7% liquid solution of biotechnologically generatednatrium-hyaluronate with a molecular weight of 1.4 million Dalton. Theresulting kneadable material was highly suitable as a plasticbone-replacement material.

1. A kneadable and moldable bone-replacement material which consists ofa mixture of: A) calcium-containing ceramic particles; and B) a hydrogelor a substance that can be swelled into a hydrogel, and wherein: C) theceramic particles are of fully synthetic origin; D) the individualceramic particles have at least a partially cohesive, porous structure;and E) the majority of the ceramic particles have a non-spheric shape.2. The bone-replacement material in accordance with claim 1, wherein theceramic particles have an angular shape.
 3. The bone-replacementmaterial in accordance with claim 1, the ceramic particles have asphericity relationship S=Dmax/Dmin between a largest diameter Dmax anda smallest diameter Dmin which is larger than 1.2.
 4. Thebone-replacement material in accordance with claim 3, wherein thesphericity relationship S is larger than
 3. 5. The bone-replacementmaterial in accordance with claim 1, wherein at least 50% of the ceramicparticles have a non-spheric shape.
 6. The bone-replacement material inaccordance with claim 1, wherein a pore size of the ceramic particles isbetween 1 and 500 micrometers.
 7. The bone-replacement material inaccordance with claim 1, wherein at least 50% of the ceramic particleshave a pore size between 100 and 500 micrometers.
 8. Thebone-replacement material in accordance with claim 7, wherein the poresize is between 1 and 100 micrometers.
 9. The bone-replacement materialin accordance with claim 8, wherein the pore size is between 340 and 450micrometers.
 10. The bone-replacement material in accordance with claim1, wherein porosity of the ceramic particles is between 60 and 90percent.
 11. The bone-replacement material in accordance with claim 1,wherein a bulk density of the ceramic particles is between 0.2 g/ccm and2.0 g/ccm.
 12. The bone-replacement material in accordance with claim 1,wherein a bulk density of the ceramic particles is between 0.6 g/ccm and1.0 g/ccm.
 13. The bone-replacement material in accordance with claim 1,wherein a bulk density of the ceramic particles is between 1.0 g/ccm and2.0 g/.
 14. The bone-replacement material in accordance claim 1, whereina jarring density of the ceramic particles is between 0.5 g/ccm and 2.5g/ccm.
 15. The bone-replacement material in accordance with claim 14,wherein the jarring density of the ceramic particles is between 0.7g/ccm and 1.1 g/ccm.
 16. The bone-replacement material in accordancewith claim 14, wherein the jarring density of the ceramic particles isbetween 1.1 g/ccm and 2.5 g/ccm.
 17. The bone-replacement material inaccordance with claim 1, wherein a share of ceramic particles ofnon-spheric shape is at least 60%.
 18. The bone-replacement material inaccordance with claim 1, wherein an average diameter of the ceramicparticles is between 100 and 250 micrometers.
 19. The bone-replacementmaterial in accordance with claim 1, wherein an average diameter of theceramic particles is between 250 and 500 micrometers.
 20. Thebone-replacement material in accordance with claim 1, wherein an averagediameter of the ceramic particles is between 0.5 and 5.6 mm.
 21. Thebone-replacement material in accordance with claim 18, wherein ceramicparticles with an average diameter of 100 to 250 micrometers are usedtogether with those having an average diameter of 250 to 500 micrometersand/or together with those having an average diameter of 0.5 to 5.6 mm.22. The bone-replacement material in accordance with claim 1, whereinthe ceramic particles consist of a calcium-phosphate having a molar Ca/Prelationship between 1.0 and 2.0.
 23. The bone-replacement material inaccordance with claim 22, wherein the ceramic particles consist of acalcium-phosphate having a molar Ca/P relationship between 1.45 and1.52.
 24. The bone-replacement material in accordance with claim 22,wherein the ceramic particles consist of a calcium-phosphate having amolar Ca/P relationship between 1.45 and 1.49.
 25. The bone-replacementmaterial in accordance with claim 22, wherein the calcium phosphate isselected from the following group: Dicalcium-phosphate-dihydrate(CaHPO4×2 H2O), dicalcium-phosphate (CaHPO4), alpha-tricalcium-phosphate(alpha-Ca3(PO4)2), beta-tricalcium-phosphate (beta-Ca3(PO4)2),calcium-deficient hydro-xylapatite (Ca9(PO4)5(HPO4)OH), hydro-xylapatite(CA10(PO4)6OH)2), carbonated apatite (Ca10(PO4)3(CO3)3(OH)2),flouride-apatite (Ca10(PO4)6(F,OH)2), chloride-apatite(Ca10(PO4)6(Cl,OH)2), whitlockite ((Ca,Mg)3(PO4)2),tetracalcium-phosphate (Ca4(PO4)2O), oxyapatite (CA10(PO4)60),beta-calcium-pyrophosphate (beta-Ca2(P2O7), alpha-calcium-pyrophosphate,gamma-calcium-pyrophosphate, octo-calcium-phosphate (Ca8H2(PO4)6×5 H2O).26. The bone-replacement material in accordance with claim 1, whereinthe ceramic particles consist of a mixture of differentcalcium-phosphates.
 27. The bone-replacement material in accordance withclaim 1, wherein the ceramic particles consist of a calcium-sulfate. 28.The bone-replacement material in accordance with claim 1, wherein theceramic particles consist of a calcium-carbonate.
 29. Thebone-replacement material in accordance with claim 1, wherein theceramic particles are selected from the following group:alpha-calcium-sulfate-hemihydrate, beta-calcium-sulfate-hemihydrate,calcium-sulfate-dihydrate.
 30. The bone-replacement material inaccordance with claim 1, wherein the ceramic particles consist of amixture of different calcium-phosphates, calcium-sulfates and/orcalcium-carbonates.
 31. The bone-replacement material in accordance withclaim 1, further comprising metallic or semi-metallic ion shares asadditives.
 32. The bone-replacement material in accordance with claim 1,wherein the hydrogel or the substance which can be swelled into ahydrogel consists of fully synthetic substances.
 33. Thebone-replacement material in accordance with claim 1, wherein thehydrogel or the substance which can be swelled into a hydrogel consistsof natural biological substances, preferably of plant origin.
 34. Thebone-replacement material in accordance with claim 1, wherein thehydrogel or the substance which can be swelled into a hydrogel consistsof a biotechnologically generated substance.
 35. The bone-replacementmaterial in accordance with claim 32, wherein the hydrogel or thesubstance which can be swelled into a hydrogel consists of a mixture offully synthetic, natural biological or biotechnologically generatedsubstances.
 36. The bone-replacement material in accordance with claim1, wherein the hydrogel or the substance which can be swelled into ahydrogel contains one of the following components: a) polyamino-acids ortheir derivatives, preferably polylysin or gelatin; b) polysaccharidesand their derivatives, preferably glycosaminoglycane or alginate; c)polylipides, fatty acids and their derivatives; d) nucleotides and theirderivatives; or a combination of the components as listed in a) throughd).
 37. The bone-replacement material in accordance with claim 1,wherein the hydrogel or the substance which can be swelled into ahydrogel contains one of the following components: a) polymethylenoxideor its derivatives; b) polyethylene, polyethylenoxide or theirderivatives; c) polypropylene, polypropylenoxide or their derivatives;d) polyacrylate or its derivatives; or a combination of the componentsas listed in a) through d).
 38. The bone-replacement material inaccordance with claim 1, wherein the hydrogel or the substance which canbe swelled into a hydrogel consists of either a glycosaminoglycane or aproteoglycane or a mixture of those two substances.
 39. Thebone-replacement material in accordance with claim 38, wherein theglycosaminoglycane is a hyaluron-acid, chondroitinsulfate,dermatansulfate, heparansulfate, heparine or keratansulfate.
 40. Thebone-replacement material in accordance with claim 1, wherein aconcentration of the ready-to-use, hydrated hydrogel or a ready-to-use,hydrated substance which can be swellen into a hydrogel is between 0.1%and 20.0%.
 41. The bone-replacement material in accordance with claim 1,wherein a molecular weight of the hydrogel or the substance which can beswelled into a hydrogel is larger than 300,000 Dalton and preferablylarger than 500,000 Dalton.
 42. The bone-replacement material inaccordance with claim 41, wherein the molecular weight of the hydrogelor the substance which can be swelled into a hydrogel is larger than1,000,000 Dalton and preferably larger than 1,500,000 Dalton.
 43. Thebone-replacement material in accordance with claim 1, wherein thehydrogel is a liquid solution of a hyaluronate.
 44. The bone-replacementmaterial in accordance with claim 43, wherein the liquid solution of thehydrogel contains less than 99% water.
 45. The bone-replacement materialin accordance with claim 43, wherein the liquid solution of the hydrogelcontains less than 96.5% water.
 46. The bone-replacement material inaccordance with claim 43, wherein the molecular weight of thehyaluron-acid used is larger than 1.5×10⁶ Dalton.
 47. Thebone-replacement material in accordance with claim 43, wherein themolecular weight of the hyaluron-acid used is between 0.5×10⁶ and1.0×10⁶ Dalton.
 48. The bone-replacement material in accordance withclaim 43, wherein the molecular weight of the hyaluron-acid used issmaller than 1×10⁶ and preferably smaller than 0.5×10⁶ Dalton.
 49. Thebone-replacement material in accordance with claim 1, wherein a specificgravity of the calcium-containing, porous ceramic particles is between0.5 and 1.0 g/ccm.
 50. The bone-replacement material in accordance withclaim 1, wherein a weight relationship A/B between the hydrated hydrogeland the calcium-containing ceramic particles is larger than 0.2.
 51. Thebone-replacement material in accordance with claim 50, wherein theweight relationship A/B is between 0.2 and 0.5.
 52. The bone-replacementmaterial in accordance with claim 50, wherein the weight relationshipA/B is between 0.5 and 0.9.
 53. The bone-replacement material inaccordance with claim 50, wherein the weight relationship A/B is between0.9 and 1.3.
 54. The bone-replacement material in accordance with claim50, wherein the weight relationship A/B is between 1.3 and 2.0.
 55. Thebone-replacement material in accordance with claim 50, wherein theweight relationship A/B is between 2 and
 5. 56. The bone-replacementmaterial in accordance with claim 50, wherein the weight relationshipA/B is larger than 5.